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Q&A with Herb Aronow, MD

Herbert Aronow, MD, MPH, is the director of interventional cardiology at the Lifespan Cardiovascular Institute of Rhode Island, Newport and The Miriam Hospitals. He also serves as director of the cardiac catheterization laboratories at Rhode Island and The Miriam hospitals. An expert in cardiovascular disease and coronary and vascular intervention, he answers a few questions about his research and what is new in field of cardiovascular medicine.

What are some of the ways the Cardiovascular Institute of Rhode Island, Newport and The Miriam Hospitals excel in research?

In addition to our faculty involvement in investigator-initiated research we typically run dozens of clinical trials across the spectrum of cardiovascular conditions. These studies help further our understanding of cardiovascular disease, facilitate its diagnosis and treatment, and in many cases allow our patients access to leading-edge interventions that would otherwise be unavailable.

What are your clinical research interests?

In the investigator-initiated arena, my interests have centered around the safety of coronary and vascular procedures. In the clinical trial arena, I have taken a particular interest in carotid stenting, where I have served as a site principal investigator on numerous randomized trials comparing revascularization modalities and comparing revascularization with medical therapy alone. I have also had a keen interest in trials evaluating novel devices for treating resistant and uncontrolled hypertension.

You are working on multiple clinical trials at Lifespan. Tell us about the studies and what you are investigating.

I am currently participating as an investigator in multiple clinical trials, with more to come. These include BEST CLI, a study comparing angioplasty with surgery for patients who have critical limb ischemia and are consequently at risk of limb loss. Another study, called Viabahn ISR and Lutonix ISR, looks at evaluating novel fabric-covered stents and drug-coated balloons, respectively, for treating restenosis in femoropopliteal stents. I am also working on Scaffold, a trial evaluating a new covered stent to reduce the stroke risk associated with carotid artery stenosis.

What do you think are the challenges being faced in the field of clinical cardiovascular research today?

Although the prevalent nature of cardiovascular disease and its associated hard outcomes, including death, myocardial infarction, stroke, etc., make it well suited for research, there are a number of longstanding challenges that limit such efforts. These include patient willingness to participate in research, provider willingness to refer patients for research, adequate investigator and institutional financial support, and the often lengthy period between design and conduct of cardiovascular drug and device studies and their ultimate approval and reimbursement.

What will be a “game changer” in the field of cardiovascular medicine?

Perhaps the biggest game changer in our field at the moment has occurred with structural heart procedures. These address conditions affecting the heart valves or chambers. While some of these are already approved, others remain under active investigation. Collectively, these procedures are performed through catheters and/or minimally invasive surgical techniques and allow patients to be treated at significantly lower risk or in some cases to be treated at all.

Lifespan, Rhode Island’s first health system, is a comprehensive, integrated, academic health system affiliated with The Warren Alpert Medical School of Brown University.